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“GROW OUR OWN DIRECTIVE: PHYSICIAN ASSISTANT EMPLOYMENT AND EDUCATION ACT OF 2017” mentioning the U.S. Dept of Labor was published in the House of Representatives section on pages H6540-H6543 on July 28, 2017.
The Department provides billions in unemployment insurance, which peaked around 2011 though spending had declined before the pandemic. Downsizing the Federal Government, a project aimed at lowering taxes and boosting federal efficiency, claimed the Department funds "ineffective and duplicative services" and overregulates the workplace.
The publication is reproduced in full below:
GROW OUR OWN DIRECTIVE: PHYSICIAN ASSISTANT EMPLOYMENT AND EDUCATION
ACT OF 2017
Mr. ROE of Tennessee. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 3262) to require the Secretary of Veterans Affairs to carry out a pilot program to provide educational assistance to certain former members of the Armed Forces for education and training as physician assistants of the Department of Veterans Affairs, to establish pay grades and require competitive pay for physician assistants of the Department, and for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 3262
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Grow Our Own Directive: Physician Assistant Employment and Education Act of 2017''.
SEC. 2. PILOT PROGRAM TO PROVIDE EDUCATIONAL ASSISTANCE TO
PHYSICIAN ASSISTANTS TO BE EMPLOYED AT THE
DEPARTMENT OF VETERANS AFFAIRS.
(a) Pilot Program.--
(1) In general.--The Secretary of Veterans Affairs shall carry out a pilot program to be known as the ``Grow Our Own Directive'' or ``G.O.O.D.'' pilot program (in this section referred to as the ``pilot program'') to provide educational assistance to certain former members of the Armed Forces for education and training as physician assistants of the Department of Veterans Affairs.
(2) Information on pilot program.--The Secretary shall provide information on the pilot program to eligible individuals under subsection (b), including information on application requirements and a list of entities with which the Secretary has partnered under subsection (g).
(b) Eligible Individuals.--An individual is eligible to participate in the pilot program if the individual--
(1) has medical or military health experience gained while serving as a member of the Armed Forces;
(2) has received a certificate, associate degree, baccalaureate degree, master's degree, or postbaccalaureate training in a science relating to health care;
(3) is not eligible to participate in educational assistance under chapter 30, 31, 32, 33, 34, or 35 of title 38, United States Code, or chapter 1606 or 1607 of title 10, United States Code;
(4) has participated in the delivery of health care services or related medical services, including participation in military training relating to the identification, evaluation, treatment, and prevention of diseases and disorders; and
(5) does not have a degree of doctor of medicine, doctor of osteopathy, or doctor of dentistry.
(c) Duration.--The pilot program shall be carried out during the five-year period beginning on the date that is 180 days after the date of the enactment of this Act.
(d) Selection.--
(1) In general.--The Secretary shall select not less than 250 eligible individuals under subsection (b) to participate in the pilot program.
(2) Priority for selection.--In selecting individuals to participate in the pilot program under paragraph (1), the Secretary shall give priority to the following individuals:
(A) Individuals who participated in the Intermediate Care Technician Pilot Program of the Department that was carried out by the Secretary between January 2011 and February 2015.
(B) Individuals who agree to be employed as a physician assistant for the Veterans Health Administration at a medical facility of the Department located in a community that--
(i) is designated as a medically underserved population under section 330(b)(3)(A) of the Public Health Service Act
(42 U.S.C. 254b(b)(3)(A)); and
(ii) is in a State with a per capita population of veterans of more than 9 percent according to the National Center for Veterans Analysis and Statistics and the United States Census Bureau.
(e) Educational Assistance.--
(1) In general.--In carrying out the pilot program, the Secretary shall provide educational assistance to individuals participating in the pilot program, including through the use of scholarships, to cover the costs to such individuals of obtaining a master's degree in physician assistant studies or a similar master's degree.
(2) Use of existing programs.--In providing educational assistance under paragraph (1), the Secretary shall use the Department of Veterans Affairs Health Professionals Educational Assistance Program under chapter 76 of title 38, United States Code, and such other educational assistance programs of the Department as the Secretary considers appropriate.
(3) Use of scholarships.--The Secretary shall provide not less than 35 scholarships under the pilot program to individuals participating in the pilot program during each year in which the pilot program is carried out.
(f) Period of Obligated Service.--
(1) In general.--The Secretary shall enter into an agreement with each individual participating in the pilot program in which such individual agrees to be employed as a physician assistant for the Veterans Health Administration for a period of obligated service specified in paragraph (2).
(2) Period specified.--With respect to each individual participating in the pilot program, the period of obligated service specified in this paragraph for the individual is--
(A) if the individual is participating in the pilot program through a program described in subsection (e)(2) that specifies a period of obligated service, the period specified with respect to such program; or
(B) if the individual is participating in the pilot program other than through a program described in such subsection, or if such program does not specify a period of obligated service, a period of three years or such other period as the Secretary considers appropriate for purposes of the pilot program.
(g) Breach.--
(1) Liability.--Except as provided in paragraph (2), an individual who participates in the pilot program and fails to satisfy the period of obligated service under subsection (f) shall be liable to the United States, in lieu of such obligated service, for the amount that has been paid or is payable to or on behalf of the individual under the pilot program, reduced by the proportion that the number of days served for completion of the period of obligated service bears to the total number of days in the period of obligated service of such individual.
(2) Exception.--If an individual is participating in the pilot program through a program described in subsection
(e)(2) that specifies a period of obligated service, the liability of the individual for failing to satisfy the period of obligated service under subsection (f) shall be determined as specified with respect to such program.
(h) Mentors.--The Secretary shall ensure that a physician assistant mentor or mentors are available for individuals participating in the pilot program at each facility of the Veterans Health Administration at which a participant in the pilot program is employed.
(i) Partnerships.--In carrying out the pilot program, the Secretary shall seek to partner with the following:
(1) Not less than 15 institutions of higher education that--
(A) offer a master's degree program in physician assistant studies or a similar area of study that is accredited by the Accreditation Review Commission on Education for the Physician Assistant; and
(B) agree--
(i) to guarantee seats in such master's degree program for individuals participating in the pilot program who meet the entrance requirements for such master's degree program; and
(ii) to provide individuals participating in the pilot program with information on admissions criteria and the admissions process.
(2) Other institutions of higher education that offer programs in physician assistant studies or other similar areas of studies that are accredited by the Accreditation Review Commission on Education for the Physician Assistant.
(3) The Transition Assistance Program of the Department of Defense.
(4) The Veterans' Employment and Training Service of the Department of Labor.
(5) Programs carried out under chapter 41 of title 38, United States Code, for the purpose of marketing and advertising the pilot program to veterans and members of the Armed Forces who may be interested in the pilot program.
(j) Administration of Pilot Program.--For purposes of carrying out the pilot program, the Secretary shall appoint or select within the Office of Physician Assistant Services of the Veterans Health Administration the following:
(1) A Deputy Director for Education and Career Development of Physician Assistants who--
(A) is a physician assistant, a veteran, and employed by the Department as of the date of the enactment of this Act;
(B) is responsible for--
(i) overseeing the pilot program;
(ii) recruiting candidates to participate in the pilot program;
(iii) coordinating with individuals participating in the pilot program and assisting those individuals in applying and being admitted to a master's degree program under the pilot program; and
(iv) providing information to eligible individuals under subsection (b) with respect to the pilot program; and
(C) may be employed in the field at a medical center of the Department.
(2) A Deputy Director of Recruitment and Retention who--
(A) is a physician assistant, a veteran, and employed by the Department as of the date of the enactment of this Act;
(B) is responsible for--
(i) identifying and coordinating the needs of the pilot program and assist the Secretary in providing mentors under subsection (h) to participants in the pilot program; and
(ii) coordinating the staff of facilities of the Veterans Health Administration with respect to identifying employment positions and mentors under subsection (h) for participants in the pilot program; and
(C) may be employed in the field at a medical center of the Department.
(3) A recruiter who--
(A) reports directly to the Deputy Director of Recruitment and Retention; and
(B) works with the Workforce Management and Consulting Office and the Healthcare Talent Management Office of the Veterans Health Administration to develop and implement national recruiting strategic plans for the recruitment and retention of physician assistants within the Department.
(4) An administrative assistant, compensated at a rate not less than level GS-6 of the General Schedule, or equivalent, who assists with administrative duties relating to the pilot program in the Office of Physician Assistant Services and such other duties as determined by the Secretary to ensure that the Office runs effectively and efficiently.
(k) Report.--
(1) In general.--Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs, in collaboration with the Secretary of Labor, the Secretary of Defense, and the Secretary of Health and Human Services, shall submit to Congress a report on the pilot program.
(2) Elements.--The report required by paragraph (1) shall include the following:
(A) The extent to which the pilot program is effective in improving the ability of eligible individuals under subsection (b) to become physician assistants;
(B) An examination of whether the pilot program is achieving the goals of--
(i) enabling individuals to build on medical skills gained as members of the Armed Forces by entering into the physician assistant workforce of the Department; and
(ii) helping to meet the shortage of physician assistants employed by the Department.
(C) An identification of such modifications to the pilot program as the Secretary of Veterans Affairs, the Secretary of Labor, the Secretary of Defense, and the Secretary of Health and Human Services consider necessary to meet the goals described in subparagraph (B).
(D) An assessment of whether the pilot program could serve as a model for other programs of the Department to assist individuals in obtaining certification and employment in other health care fields.
(l) Source of Amounts.--Not less than $8,000,000 of the amount necessary to carry out the pilot program shall be derived from amounts appropriated to the Department of Veterans Affairs before the date of the enactment of this Act.
SEC. 3. ESTABLISHMENT OF STANDARDS FOR THE DEPARTMENT OF
VETERANS AFFAIRS FOR USING EDUCATIONAL
ASSISTANCE PROGRAMS TO EDUCATE AND HIRE
PHYSICIAN ASSISTANTS.
(a) In General.--The Secretary of Veterans Affairs shall establish standards described in subsection (b) to improve the use by the Department of Veterans Affairs of the Department of Veterans Affairs Health Professionals Educational Assistance Program under chapter 76 of title 38, United States Code, and other educational assistance programs of the Department, including the pilot program under section 2, to educate and hire physician assistants of the Department.
(b) Standards.--The standards described in this subsection are the following:
(1) Holding directors of medical centers of the Department accountable for failure to use the educational assistance programs described in subsection (a) and other incentives--
(A) to advance employees of the Department in their education as physician assistants; and
(B) to improve recruitment and retention of physician assistants.
(2) Ensuring that the Department of Veterans Affairs Education Debt Reduction Program under subchapter VII of chapter 76 of such title is available for participants in the pilot program under section 2 to fill vacant physician assistant positions at the Department, including by--
(A) including in all vacancy announcements for physician assistant positions the availability of the Education Debt Reduction Program; and
(B) informing applicants to physician assistant positions of their eligibility for the Education Debt Reduction Program.
(3) Monitoring compliance with the application process for educational assistance programs described in subsection (a) to ensure that such programs are being fully utilized to carry out this section.
(4) Creating programs, including through the use of the Department of Veterans Affairs Employee Incentive Scholarship Program under subchapter VI of chapter 76 of such title, to encourage employees of the Department to apply to accredited physician assistant programs.
(c) Regulations.--The Secretary shall prescribe such regulations as the Secretary considers appropriate to carry out this section.
SEC. 4. EXTENSION OF REQUIREMENT FOR COLLECTION OF FEES FOR
HOUSING LOANS GUARANTEED BY SECRETARY OF
VETERANS AFFAIRS.
Section 3729(b)(2) of title 38, United States Code, is amended--
(1) in subparagraph (A)--
(A) in clause (iii), by striking ``September 30, 2024'' and inserting ``December 31, 2024''; and
(B) in clause (iv), by striking ``September 30, 2024'' and inserting ``December 31, 2024'';
(2) in subparagraph (B)--
(A) in clause (i), by striking ``September 30, 2024'' and inserting ``December 31, 2024''; and
(B) in clause (ii), by striking ``September 30, 2024'' and inserting ``December 31, 2024'';
(3) in subparagraph (C)--
(A) in clause (i), by striking ``September 30, 2024'' and inserting ``December 31, 2024''; and
(B) in clause (ii), by striking ``September 30, 2024'' and inserting ``December 31, 2024''; and
(4) in subparagraph (D)--
(A) in clause (i), by striking ``September 30, 2024'' and inserting ``December 31, 2024''; and
(B) in clause (ii), by striking ``September 30, 2024'' and inserting ``December 31, 2024''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from Tennessee (Mr. Roe) and the gentleman from Minnesota (Mr. Walz) each will control 20 minutes.
The Chair recognizes the gentleman from Tennessee.
General Leave
Mr. ROE of Tennessee. Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and include extraneous material.
The SPEAKER pro tempore. Is there objection to the request of the gentleman from Tennessee?
There was no objection.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in support of H.R. 3262, as amended, the Grow Our Own Directive--or GOOD--Physician Assistant Employment and Education Act of 2017.
The PA profession has a long and storied connection with veterans as the first class of PAs was primarily composed of Army medics and Navy corpsmen who served in the Vietnam war.
And I might add, when I did basic training at San Antonio, Texas, at Fort Sam, one of the first PA classes was there.
Today, the Department of Veterans Affairs is the single largest employer of PAs in the country. Nevertheless, PAs are consistently identified as one of the top five professions where VA is experiencing the largest staffing shortages.
H.R. 3262, as amended, would help solve that by creating a pilot program to provide assistance to veterans who want to pursue education and training to become a PA and to serve their fellow veterans by working at VA medical facilities.
I am grateful to Congresswoman Ann Kuster for sponsoring this legislation and shepherding it through the legislative process, and I am confident that it will go a long way in resolving existing PA recruitment and retention issues, ensuring that VA medical facilities are appropriately staffed with high-quality PAs and, in turn, increasing access to care for veteran patients.
Mr. Speaker, I urge all of my colleagues to join me in supporting H.R. 3262, as amended, and I reserve the balance of my time.
{time} 1115
Mr. WALZ. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I, too, rise in support of H.R. 3262, as amended, the GOOD Act of 2017, which was introduced by a good friend, someone who has proven herself to be a dogged champion of veterans, the ranking member of the Oversight and Investigations Subcommittee, Ms. Kuster. This important piece of legislation will allow veterans who served as medics and corpsmen in the military to receive scholarships to train as physician assistants.
The VA has over 45,000 provider vacancies to fill so that veterans are not waiting too long for care. In the United States, we face a provider shortage in general, especially in our rural communities, where most veterans live. This bill will help address these critical shortages by providing veterans with an incredible opportunity to aid their communities and their fellow veterans.
Ms. Kuster's hard work on this legislation and on behalf of veterans is admirable, and I urge my colleagues to support this bill.
Mr. Speaker, I reserve the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, it is my privilege to yield 2 minutes to the gentleman from Michigan (Mr. Bergman), who is the chairman of the Subcommittee on Oversight and Investigations on the full Veterans' Affairs Committee.
Mr. BERGMAN. Mr. Speaker, for years, the Department of Veterans Affairs has seen many of its medical personnel leave to pursue opportunities outside of the VA healthcare system, resulting in fewer healthcare providers and, ultimately, less access to care for our veterans. In the First District of Michigan, which I represent, we are largely a rural district, and our district and our veterans have suffered more than most on this.
The GOOD Act utilizes a two-pronged approach to address VA's continuing struggles in recruiting and retaining their physician assistant workforce. This bill creates a pilot program to provide that pathway for veterans to receive the education necessary to become a PA while, simultaneously, requiring the VA to establish a national strategic plan to recruit and retain a robust and long-term medical staff.
Our veterans have given so much for our country at exceptional costs, and they deserve access to timely and high-quality healthcare from skilled professionals. I am proud to join Ranking Member Kuster from our Oversight and Investigations Subcommittee in supporting this bipartisan legislation on behalf of our Nation's veterans.
Mr. Speaker, I urge all of my colleagues to support the bill, H.R. 3262.
Mr. WALZ. Mr. Speaker, it is my pleasure to yield 5 minutes to the gentlewoman from New Hampshire (Ms. Kuster), the author of this piece of legislation, the ranking member of the Subcommittee on Oversight and Investigations.
Ms. KUSTER of New Hampshire. Mr. Speaker, I rise to join my colleague, General Bergman, in support of our bill, H.R. 3262, the Grow Our Own Directive: Physician Assistant Employment and Education Act of 2017.
The Department of Veterans Affairs and the entire Nation are experiencing a shortage of quality physicians and healthcare providers. For doctors alone, the Association of American Medical Colleges estimates that, by 2030, the country could face a doctor shortage of over 100,000 physicians. Access to care will only become a harder problem to solve the longer it takes to be addressed.
Nonphysician providers, like physician assistants, are an important part of the solution to this shortage. Physician assistants are highly trained providers that often focus their training on specialties like psychiatry, orthopedics, and internal medicine.
It is fitting that my bill would help get more PAs into the VA to serve veterans. After all, the profession started when a small group of four Navy corpsmen completed the first PA program started at Duke University. That first program was based on the fast-tracked training of doctors during World War II. Veterans and the military have always been a part of the physician assistant profession.
The PA workforce offers unique value to rural and underserved areas. In places like northern New Hampshire, in my district, PAs help resolve shortages for family physicians and primary care physicians, shortages that have existed for decades.
My bill would leverage the Department of Veterans Affairs to improve access to quality care for veterans and rural locations alike. It would create a pilot scholarship program that awards no less than 250 scholarships over 5 years to PAs.
Currently, the VA has approximately 2,000 PAs. My bill would increase the PA workforce at the VA by over 10 percent.
In exchange for these scholarships, PAs would be required to work at the VA, and their placement would be focused on sending providers to rural and underserved areas. We know that if a provider is placed in New Hampshire, they tend to stay there.
This bill would also help get veterans with medical training in the workforce and with good-paying jobs. It is crucial that we help our veterans find excellent career paths that utilize the skills they learned while in the military service, and it is an added bonus that these veterans get to take care of their brothers and sisters in arms.
The final provision in my bill was included in the Choice funding bill we debated just moments ago. This provision would provide PAs in the VA with competitive pay based on the community they serve. This provision is crucial because it helps recruit and retain these critical providers. The GAO recently reported that PAs experience the highest loss rate of any critical occupation, higher than doctors and nurse practitioners.
I would like to applaud my colleagues for coming together in a bipartisan way to craft the Choice funding bill. Not only will the bill fund the Choice Program for another 6 months, but it includes a number of important reforms that will improve service for all of our veterans. These provisions include improved authority for hiring in job shortage areas, measures to increase accountability within the VA, and my provision to boost the pay of PAs.
I would like to thank my esteemed colleague on the House Veterans Affairs' Subcommittee on Oversight and Investigations, Chairman Bergman. His support for this legislation was crucial to its passage today. I thank our chairman, Dr. Roe, and our ranking member.
Mr. Speaker, I ask my colleagues to immediately pass this bill.
Mr. ROE of Tennessee. Mr. Speaker, I reserve the balance of my time.
Mr. WALZ. Mr. Speaker, as you heard, I urge my colleagues to support this smart piece of legislation. But I would like to close by adding, also, a thank-you to the chairman and to the majority side, once again showing bipartisanship offering two bills introduced by our side of the aisle that are being heard here on the floor which can be signed into law. It is greatly appreciated. It shows that the care of veterans always comes first. We on the minority side are appreciative of that courtesy.
Mr. Speaker, I urge my colleagues to support the bill, and I yield back the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I certainly support this bill, and I want to thank both General Bergman and Ms. Kuster. We made a trip to Afghanistan together a couple of years ago. She has a dogged--and I will say ``dogged''--
commitment to the veterans in her district and to this country, and I want to thank her for bringing this piece of legislation up. I believe it will make a difference, I truly do, when it is implemented.
And I want to thank the ranking member, and his staff and mine, for bringing a lot of pieces of legislation to the House floor in the last couple of weeks. This week, especially, we have had some success here, and that means veterans had success. Certainly, the post-9/11 GI Bill that was passed this week is an enormous bill and will do good generations after no one ever remembers who was on this floor debating that bill. So I want to thank them and thank my colleagues and wish everyone a safe recess and a healthy recess.
Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore (Mr. Shimkus). The question is on the motion offered by the gentleman from Tennessee (Mr. Roe) that the House suspend the rules and pass the bill, H.R. 3262, as amended.
The question was taken; and (two-thirds being in the affirmative) the rules were suspended and the bill, as amended, was passed.
The title of the bill was amended so as to read: ``A bill to require the Secretary of Veterans Affairs to carry out a pilot program to provide educational assistance to certain former members of the Armed Forces for education and training as physician assistants of the Department of Veterans Affairs, and for other purposes.''.
A motion to reconsider was laid on the table.
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